BACKGROUND: We examined waiting time for adult heart transplantation in the UK and sought to determine whether recipients with particular ABO blood groups were disadvantaged. METHODS: Data were obtained from the National Transplant Database. Registration outcome data were analyzed for 622 new, non-urgent, adult, heart-only registrations from April 1, 1999 to March 31, 2003. Unadjusted waiting times of the 618 first registrations were summarized using Kaplan-Meier estimates. RESULTS: Death rates were relatively low, with no significant difference in the proportions of patients among the different blood groups who died while waiting. A smaller proportion of blood group O patients were transplanted at 1 year after registration, with a significant difference in waiting time to transplant between blood groups (p < 0.0001). Blood group A and AB patients were generally transplanted sooner than O and B patients, with median waiting times of 81 days (95% CI: 67 to 114) and 76 days (95% CI: 52 to 178) vs 214 days (95% CI: 162 to 308) and 174 days (95% CI: 78 to 249), respectively. CONCLUSIONS: Although no particular blood group was disadvantaged in terms of mortality on the heart transplant list, blood group O and B patients waited significantly longer for transplantation. The difference was at least partly due to a large proportion of blood group O hearts being used for non-O patients. To address this imbalance, the UK Transplant Cardiothoracic Advisory Group (CTAG) changed the allocation protocol, so that "out-of-zone" offers of blood group O donors for non-urgent patients are now restricted to O and B recipients.
BACKGROUND: We examined waiting time for adult heart transplantation in the UK and sought to determine whether recipients with particular ABO blood groups were disadvantaged. METHODS: Data were obtained from the National Transplant Database. Registration outcome data were analyzed for 622 new, non-urgent, adult, heart-only registrations from April 1, 1999 to March 31, 2003. Unadjusted waiting times of the 618 first registrations were summarized using Kaplan-Meier estimates. RESULTS: Death rates were relatively low, with no significant difference in the proportions of patients among the different blood groups who died while waiting. A smaller proportion of blood group O patients were transplanted at 1 year after registration, with a significant difference in waiting time to transplant between blood groups (p < 0.0001). Blood group A and ABpatients were generally transplanted sooner than O and B patients, with median waiting times of 81 days (95% CI: 67 to 114) and 76 days (95% CI: 52 to 178) vs 214 days (95% CI: 162 to 308) and 174 days (95% CI: 78 to 249), respectively. CONCLUSIONS: Although no particular blood group was disadvantaged in terms of mortality on the heart transplant list, blood group O and B patients waited significantly longer for transplantation. The difference was at least partly due to a large proportion of blood group O hearts being used for non-O patients. To address this imbalance, the UK Transplant Cardiothoracic Advisory Group (CTAG) changed the allocation protocol, so that "out-of-zone" offers of blood group O donors for non-urgent patients are now restricted to O and B recipients.
Authors: Benjamin A Goldstein; Laine Thomas; Jonathan G Zaroff; John Nguyen; Rebecca Menza; Kiran K Khush Journal: Epidemiology Date: 2016-07 Impact factor: 4.822
Authors: Aditi Nayak; Tiffany Dong; Yi-An Ko; Neile Chesnut; Ann Pekarek; Robert T Cole; Kunal Bhatt; Divya Gupta; Michael A Burke; S Raja Laskar; Tamer Attia; Andrew L Smith; J David Vega; Alanna A Morris Journal: Clin Transplant Date: 2020-02-28 Impact factor: 2.863
Authors: Yaron D Barac; Mike S Mulvihill; Morgan L Cox; Muath Bishawi; Jacob Klapper; John Haney; Mani Daneshmand; Matthew G Hartwig Journal: J Heart Lung Transplant Date: 2018-09-25 Impact factor: 10.247